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Whether you're a CRVS expert or just starting to learn about CRVS systems, you will enjoy exploring our range of resources. Discover more about strengthening and innovating CRVS systems, plus learn from our countries' challenges, experiences and successes.


Addressing critical knowledge and capacity gaps to sustain CRVS system development thumbnail
Addressing critical knowledge and capacity gaps to sustain CRVS system development

This paper discusses the need for any strategy aimed at building CRVS workforce capacity to be underpinned by a repository of knowledge and body of evidence on CRVS and targeted strategies to train the CRVS workforce.

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Authors: Adair, T, Richards, N, Streatfield, A, Rajasekhar, M, McLaughlin, D, Lopez, A

Publication date: March 2020

Resource type: CRVS peer-reviewed publication

Source: BMC Medicine


ANACONDA: a new tool to improve mortality and cause of death data thumbnail
ANACONDA: a new tool to improve mortality and cause of death data

This paper discusses the utility of the ANACONDA tool for countries looking to improve the reliability and timeliness of their mortality data.

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Authors: Mikkelsen, L, Moesgaard, K, Hegnauer, M, Lopez, A

Publication date: March 2020

Resource type: CRVS peer-reviewed publication

Source: BMC Medicine


Thumbnail for paper: Are cause of death data fit for purpose_20 countries
Are cause of death data fit for purpose? Evidence from 20 countries at different levels of socio-economic development

Many countries have used the new ANACONDA tool to assess the quality of their cause of death data (COD), but no cross-country analysis has been done to verify how different or similar patterns of diagnostic errors and data quality are in countries or how they are related to the local cultural or epidemiological environment or to levels of development. The study assesses whether the usability of COD data and the patterns of unusable codes are related to a country’s level of socio-economic development.

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Authors: Iburg, K M, Mikkelsen, L, Adair, T, Lopez, A D

Publication date: August 2020

Resource type: CRVS peer-reviewed publication

Source: PLoS ONE


Automated verbal autopsy: from research to routine use in civil registration and vital statistics systems thumbnail
Automated verbal autopsy: from research to routine use in civil registration and vital statistics systems

This paper reports on the application of the SmartVA tool for the collection and analysis of COD data in four countries (Myanmar, Papua New Guinea, Bangladesh, Philippines), as part of routine CRVS activities.

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Authors: Hazard, R, Buddhika, M, Hart, J, Chowdhury, H, Firth, S, Joshi, R, Avelina, F, Segarra, A, Sarmiento, D C, Azad, A K, Ashrafi, S A A, Bo, K S, Kwa, V, Lopez, A 

Publication date: March 2020

Resource type: CRVS peer-reviewed publication

Source: BMC Medicine


Better data for better outcomes: the importance of process mapping and management in CRVS systems thumbnail
Better data for better outcomes: the importance of process mapping and management in CRVS systems

This paper discusses the importance of process management to strengthen the efficiency and quality of CRVS systems, presenting experiences from countries supported through the Bloomberg Philanthropies Data for Health Initiative at the University of Melbourne.

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Authors: Cobos Muñoz, D, de Savigny, D, Sorchik, R, Bo, K S, Hart, J, Kwa, V, Ngomituje, X, Richards, N, Lopez, A D

Publication date: March 2020

Resource type: CRVS peer-reviewed publication

Source: BMC Medicine


CRVS and health
Civil registration and vital statistics in health systems

Over the past decades, the health sector has forged a widespread network of health facilities and community health workers who carry out key public health interventions, aiming to reach the most marginalized populations with life-saving interventions. In many countries, health networks offer untapped potential to leverage health services for the notification and registration of births and deaths.

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Authors: Jackson D, Wenz K, Muniz M, Abouzahr C, Schmider A, Braschi MW, Kassam N, Diaz T, Mwamba R, Setel P, Mills S

Publication date: December 2018

Resource type: CRVS peer-reviewed publication

Source: Bulletin of the World Health Organization http://dx.doi.org/10.2471/BLT.18.213090


Thumbnail_Fellow report_Marli and Luiz
Estimating completeness of national and subnational death reporting in Brazil: application of record linkage methods

In Brazil, both the Civil Registry (CR) and Ministry of Health (MoH) Mortality Information System (SIM) are sources of routine mortality data, but neither is 100% complete. This study links deaths from these to facilitate an estimation of completeness of mortality reporting and measurement of adjusted mortality indicators using generalised linear modeling (GLM).

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Author: Luiz Fernando Lima Costa, Marli de Mesquita Silva Montenegro, Dacio de Lyra Rabello Neto, Antonio Tadeu Ribeiro de Oliveira, Jose Eduardo de Oliveira Trindade, Tim Adair and Maria de Fatima Marinho

Publication date: September 2020

Resource type: CRVS peer-reviewed publication


Strengthening mortality data for health policy and planning: the Bloomberg Data for Health Initiative in Latin America (Portuguese) thumbnail
Fortalecimento dos dados de mortalidade para políticas e planejamento de saúde: a Iniciativa Bloomberg para a Saúde na América Latina thumbnail
Fortalecimento dos dados de mortalidade para políticas e planejamento de saúde: a Iniciativa Bloomberg para a Saúde na América Latina

Portuguese translation of paper: Strengthening mortality data for health policy and planning: the Bloomberg Data for Health Initiative in Latin America. This paper charts efforts and outcomes achieved through the Bloomberg Data for Health Initiative to improve mortality data in four Latin American countries since 2014: Brazil, Peru, Ecuador and Colombia.

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Authors: McLaughlin, D and Lopez, A

Publication date: December 2019

Resource type: CRVS peer-reviewed publication

Related resources: Strengthening mortality data for health policy and planning: the Bloomberg Data for Health Initiative in Latin America [English] 

Source: Rev. bras. epidemiol. vol.22  supl.3 Rio de Janeiro  2019  Epub Dec 05, 2019


WHOBulletin
How can we accelerate progress on civil registration and vital statistics?

The first in a series of papers published by the WHO Bulletin looking at how the health sector can contribute towards strengthening CRVS systems and increasing birth and death registration coverage.

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Authors: AbouZahr C, Bratschi MW, Cobos Munoz D, Santon R, Richards N, Riley I, Setel P

Publication date: April 2018

Resource type: CRVS peer-reviewed publication

Source: Bulletin of the World Health Organization http://dx.doi.org/10.2471/BLT.18.211086


WHO Bulletin: Improving coverage of civil registration and vital statistics, Bangladesh thumbnail
Improving coverage of civil registration and vital statistics, Bangladesh

In 2016, the government of Bangladesh introduced a pilot project to strengthen the civil registration and vital statistics system and generate cause of death data in Kaliganj Upazila. This paper presents the relevant changes and lessons learnt resulting from this intervention.

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Author: Moyeen Uddin, Shah Ali Akbar Ashrafi, Abul Kalam Azad, Anir Chowdhury, Hafizur Rahman Chowdhury, Ian Douglas Riley, Andres Montes, Martin Bratschi, Carla AbouZahr & Zeaul Alam

Publication date: September 2019

Resource type: CRVS peer-reviewed publication

Related resources: CRVS country overview: Bangladesh


Improving medical certification of cause of death: effective strategies and approaches based on experiences from the Data for Health Initiative thumbnail
Improving medical certification of cause of death: effective strategies and approaches based on experiences from the Data for Health Initiative

Accurate completion of the medical certificate of cause of death should be a relatively straightforward procedure for physicians, but mistakes are common. This paper presents three training strategies implemented in five countries supported by the Bloomberg Philanthropies Data for Health (D4H) Initiative at the University of Melbourne (UoM) and evaluate the impact on the quality of certification.

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Authors: Hart, J, Sorchik, R, Bo, K S, Chowdhury, H R, Gamage, S, Joshi, R, Kwa, V, Li, H, Mahesh, B, McLaughlin, D, Mikkelsen, L, Miki, J, Napulan, R, Rampatige, R, Reeve, M, Sarmiento, C, War, N S, Richards, N, Riley, I D, Lopez, A D

Publication date: March 2020

Resource type: CRVS peer-reviewed publication

Source: BMC Medicine


Improving the quality of cause of death data for public health policy: are all 'garbage' codes equally problematic? thumbnail
Improving the quality of cause of death data for public health policy: are all 'garbage' codes equally problematic?

Commentary on a classification of garbage codes that helps to identify codes unhelpful for public health policy and which are used frequently by physicians to certify deaths. This typology can be used by countries to identify the pattern and extent of garbage coding in their cause of death data.

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Authors: Neghavi, M, Richards, N, Chowdhury, H, Eynstone-Hinkins, J, Franca, E, Hegnauer, M, Khosravi, A, Moran, L, Mikkelsen, L, Lopez, A D

Publication date: March 2020

Resource type: CRVS peer-reviewed publication

Source: BMC Medicine


Integrating community-based verbal autopsy into CRVS: System-level considerations
Integrating community-based verbal autopsy into CRVS: System-level considerations

This document provides recommendations for integrating VA processes into CRVS, which involves consideration of system-wide integration issues.

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Authors: de Savigny D, Riley I, Chandramohan D, Odhiambo F, Nichols E, Notzon S, AbouZahr C, Mitra R, Cobos Munoz D, Firth S, Maire N, Sankoh O, Bronson G, Setel P, Byass P, Jakob P, Boerma T, Lopez AD

Publication date: January 2017

Resource type: CRVS peer-reviewed publication

Related resources: Summary: Integrating verbal autopsy into CRVS systems

Source: Global Health Action


Investigation of garbage code deaths to improve the quality of cause of death in Brazil thumbnail
Investigation of garbage code deaths to improve the quality of cause-of-death in Brazil: results from a pilot study

Reliable cause-of-death statistics are an important source of information on trends and differentials in population health. In Brazil, the Mortality Information System is responsible for compiling cause of death data. Despite the success in reducing R-codes ill-defined causes of death, other garbage codes, classified as causes that cannot be the underlying cause of death, according to the Global Burden of Disease study, remain a challenge. The Ministry of Health aims to decrease the proportion of all garbage codes, and a pilot study tested a comprehensive strategy to investigate garbage code deaths that occurred in 2015. This paper, a CRVS Fellowship project, presents the results of this pilot study.

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Authors: Barbosa de Lima, R, Frederes, A, Marinho, M, Candida de Cunha, C, Adair, T, Barboza Franca, E

Publication date: November 2019

Resource type: CRVS peer-reviewed publication

Source: Rev. bras. epidemiol. [online]. 2019, vol.22, suppl.3


Thumbnail image for death registration completeness in China
Measuring the completeness of death registration in 2844 Chinese counties in 2018

Death registration completeness has never been assessed at the county level in China. This paper, published in BMC Medicine, estimates the completeness of death registration for 31 provinces and 2844 counties of China in 2018 based on death data from the China Cause of Death Reporting System using the empirical completeness method.

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Authors: Zeng, X., et al.

Publication date: 2020

Resource type: CRVS peer-reviewed publication

Source: BMC Medicine


Monitoring progress in reducing maternal mortality using verbal autopsy methods in vital registration systems: what can we conclude about specific causes of maternal death? thumbnail
Monitoring progress in reducing maternal mortality using verbal autopsy methods in vital registration systems: what can we conclude about specific causes of maternal death?

Reducing maternal mortality is a key focus of development strategies and one of the indicators used to measure progress towards achieving the Sustainable Development Goals. In the absence of medical certification of the cause of deaths that occur in the community, verbal autopsy (VA) methods are the only available means to assess levels and trends of maternal deaths that occur outside health facilities.

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Authors: Riley, I.D., et al.

Publication date: 2019

Resource type: CRVS peer-reviewed publication

Source: BMC Medicine


Preliminary results of strengthening the national death registry information system of Peru thumbnail
Preliminary results of strengthening the national death registry information system of Peru

Peru has low coverage of deaths with a cause (54%) and about 30% of causes of death are classified as poorly-defined or not very useful for the formulation of public policies. In response to these problems, the Ministry of Health together with other government agencies, with the support of D4H, is implementing the National Death Registry Information System (SINADEF). The objective of this article is to describe the process of strengthening the mortality information system in Peru, focused on the implementation of SINADEF. Since the implementation of SINADEF in August 2016 until July 2018, 28,407 users of the SINADEF application have been created and a total of 122,411 deaths have been registered. The quality of data recording, including the cause of death, has been improved, while low coverage of deaths with a cause of death still persists.

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Authors: Vargas-Herrera J, Ruiz KP, Nunez GG, Ohno JM, Perez-Lu, JE, Huarcaya WV, Clapham B, Cortez-Escalante J

Publication date: October 2018

Resource type: CRVS peer-reviewed publication

Related resources: Peru: An exceptional example of CRVS system advancement

Source: Rev Peru Med Exp Salud Publica. 2018; 35(3):505-14


Reducing ignorance about who dies of what: research and innovation to strengthen CRVS systems thumbnail
Reducing ignorance about who dies of what: research and innovation to strengthen CRVS systems

Overview paper for a CRVS series published in BMC Medicine. The article collection provides an overview of recent innovations, progress, viewpoints and key areas in which action is still required – notably around the need for better systems and procedures to notify the fact of death and to reliably diagnose its cause, both for deaths in hospital and elsewhere.

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Authors: Lopez, A D, McLaughlin, D, Richards, N

Publication date: March 2020

Resource type: CRVS peer-reviewed publication

Source: BMC Medicine


Resultados preliminares del fortalecimiento del Sistema Informatico Nacional de Defunciones thumbnail
Resultados preliminares del fortalecimiento del Sistema Informatico Nacional de Defunciones

El Perú tiene una baja cobertura de defunciones con causa de defunción (54 %) y una mala calidad del registro de las causas de defunción, mas de 45 % de las causas de muerte se clasifican como mal definidas o poco útiles para la formulación de políticas públicas. En respuesta a estos problemas, el Ministerio de Salud, junto a otras agencias gubernamentales, con el apoyo de la Iniciativa Bloomberg «Información para la Salud» está implementando el Sistema Informático Nacional de Defunciones (SINADEF). El objetivo de este artículo es describir el proceso de fortalecimiento del sistema de información de la mortalidad en Perú, centrado en la implementación del SINADEF.

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Authors: Vargas-Herrera J, Ruiz KP, Nunez GG, Ohno JM, Perez-Lu, JE, Huarcaya WV, Clapham B, Cortez-Escalante J

Publication date: October 2018

Resource type: CRVS peer-reviewed publication

Related resources: Peru: An exceptional example of CRVS system advancement

Source: Rev Peru Med Exp Salud Publica. 2018; 35(3):505-14


Saving lives through certifying deaths: assessing the impact of two interventions to improve cause of death data in Perú thumbnail
Saving lives through certifying deaths: assessing the impact of two interventions to improve cause of death data in Perú

Mortality statistics derived from cause of death data are an important source of information for population health monitoring, priority setting and planning. However, the quality of cause of death data is poor. In August 2016, the Ministry of Health of Perú decided to make two specific interventions to improve cause of death data: to introduce an online death certification system and to train doctors in standard death certification practices. This study demonstrates how the two interventions improved the correctness of death certificates. The study also provides evidence on necessary changes to the training program to address the poor certification practices that have remained after implementation of the online system.

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Authors: Miki J, Rampatige R, Richards N, Adair T, Cortez-Escalante J, Vargas-Herrera J

Publication date: December 2018

Resource type: CRVS peer-reviewed publication

Related resources: Fellowship profile: Assessing the impact of death certification interventions in Peru

Source: BMC Public Health https://doi.org/10.1186/s12889-018-6264-1 


The 'Ten CRVS Milestones' framework for understanding CRVS systems
The 'Ten CRVS Milestones' framework for understanding CRVS systems

Describes how CRVS systems function, including key processes that must be accomplished. Provides an understanding of system strengths and weaknesses.

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Authors: Muñoz DC, AbouZahr C, de Savigny D

Publication date: February 2018

Resource type: CRVS peer-reviewed publication

Related resources: Understanding CRVS systems: The importance of process mapping

Source: BMJ Global Health


Where there is no hospital: improving the notification of community deaths thumbnail
Where there is no hospital: improving the notification of community deaths

This paper presents case studies in four countries (Bangladesh, Colombia, Myanmar and Papua New Guinea) that were part of the initial phases of the Bloomberg Data for Health Initiative at the University of Melbourne, each of which faces unique challenges to community death registration.

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Authors: Adair, T, Rajasekhar, M, Bo, K S, Hart, J, Kwa, V, Mukut M A A, Reeve, M, Richards, N, Ronderos-Torres, M, de Savigny, D, Cobos Muñoz, D, Lopez, A D

Publication date: March 2020

Resource type: CRVS peer-reviewed publication

Source: BMC Medicine

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